Trauma is the major cause of morbidity and mortality in otherwise healthy adults, with 3000 people dying and 30 000 being injured every day on the world's roads. Trauma is the leading cause of death in the first three decades of life and millions are injured each year and survive. For many, the injury causes temporary pain and inconvenience but for some it leads to disability, chronic pain and a profound change in lifestyle. Preventive public health measures such as safety belts and health and safety laws are the key to decreasing these numbers. Trauma deaths occur in three peaks.

• Peak 1 refers to 'immediate' deaths at the scene of an accident due to lethal and usually untreatable injuries.

• Peak 2 describes deaths occurring in the first few hours after injury. These early deaths are usually due to airway, breathing and circulation failure or head injury. They may be prevented by early treatment during what is called the golden hour of trauma resuscitation.

• Peak 3 deaths occur weeks or months after the injury. These late deaths usually occur in the critical care unit and are due to sepsis and multiple organ failure.

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